The Efficacy of Backward Walking on Static Stability, Proprioception, Pain, and Physical Function of Patients with Knee Osteoarthritis: A Randomized Controlled Trial.

Jiatao Wu,Zehua Chen,Huai Wu,Wei Lei,Tao Jiang,Xuemeng Xu,Yi Wang,Zhen Shen,Xiangling Ye,Weijian Chen

doi:10.1155/2021/5574966

Abstract

Objective Impaired static stability and proprioception have been observed in individuals with knee osteoarthritis (KOA), which serves as a major factor increasing risk of fall. This study aimed to investigate the effects of backward walking (BW) on static stability, proprioception, pain, and physical function in KOA patients. Methods Thirty-two subjects with knee osteoarthritis were randomly assigned to either an BW group (BG, n = 16) or a control group (CG, n = 16). The participants in the BG received combination treatment of a 4-week BW training and conventional treatments, while those in the CG was treated with conventional treatments alone. All the participants were tested for the assessment of static stability [center of pressure (COP) sway, including sway length (SL, mm) and sway area (SA, mm2)] and proprioception [average trajectory error (ATE, %) and completion time (CT, second)]. Additionally, pain and knee function scores were measured by the numerical rating scale (NRS) and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index, respectively. The assessments were conducted before and after intervention. Results The COP sway (SA and SL), ATE, NRS, and WOMAC showed a significant decline at week 4 in the two groups in contrast to their baseline (P < 0.05). Moreover, after 4-week intervention, the SA [(610.50 ± 464.26) mm2 vs. (538.69 ± 420.52) mm2], NRS [(1.56 ± 0.63) vs. (2.25 ± 0.86)], and WOMAC [(11.69 ± 2.50) vs. (16.19 ± 3.94)] showed a significantly greater decrease in the BG compared to the CG (P < 0.05, respectively). However, the proprioception (ATE and CT) was closely similar between both groups at week 4 (P > 0.05). Conclusion BW is an effective adjunct to conventional treatment in reducing pain, improving physical function and static stability for KOA patients. It should be taken into consideration when developing rehabilitation programs for people with KOA.

Highlights

Knee osteoarthritis (KOA), as a common disease, heavily compromises the health of the elderly
Thirty-two included participates were randomly assigned to the BW group (BG) (3 males and 13 females) or the control group (CG) (3 males and 13 females). e flow chart of the participants of this randomized controlled trial (RCT) was illustrated in Figure 1. e age, gender, weight, height, body mass index (BMI), and Kellgren/Lawrence [28] (K/L) of the two groups were closely similar
Increasing number of studies reported the benefits of backward walking (BW) for balance improvement. e present randomized, controlled trial investigated the effect of BW on static stability, proprioception, pain, and function in patients with knee osteoarthritis. e results of this study showed that SA, numerical rating scale (NRS), WOMAC, pain, and function had a significantly greater change after 4-week intervention in the BG than those in the CG, which revealed that, compared to the CG treated with conventional methods alone, BW as an adjunctive intervention in coordination with conventional treatments had a more favorable effect on static stability

Summary

Introduction

Knee osteoarthritis (KOA), as a common disease, heavily compromises the health of the elderly. With the growing population of obesity and aging, the prevalence of KOA will become higher, which has been a serious global health concern [1]. Posture control is viewed as a key factor for the incidence of falls. Imbalance in the center of gravity of the body could reduce stability and increases the risk of falls [6], which would result in bone fractures or fatal injuries for older adults. Proprioception could influence the ability of limb coordination, which played a great role in postural control [7]

Methods

Results

Conclusion